Drugs For Hypercholesterolemia And Hyperlipidemia Flashcards
Predominant two sources of circulating cholesterol
Synthesis from liver and peripheral tissues
Absorption from the intestine
Risk factors for chd
The lower cholesterol, lower risk of chd
May increase hepatic ldl receptor activity
Decreased cholesterol contribution
Majority of cholesterol delivered to the intestine is from
Biliary cholesterol excretion
Primary goal of therapy
Dec LDL-C levels
Enzyme involved in the rate limiting step of cholesterol synthesis
HMg-CoA reductase
Only ______ is COMPLETELY absorbed
Fluvastatin
Hmgcoa reductase inhibitor ae
Hepatotoxicity
Myopathy
Safest combination with statins
FENOFIBRATE
Bile acid sequestrants
Bind bile acids in the lumen and prevent absorption
Cholestyramine and colestipol-2nd line drugs
Indication-digitalis glycosides
Side effects-safe, not systematically absorbed
Niacin
Inc HDL-C
Ae: vasodilation- alleviated by aspirin;pruritus;most common-hepatotoxicity, hyperglycemia, hyperuricemia(allopurinol can be coadministered
Fibric acid derivatives
Moderately inc HdL; ligand for nuclear transcription regulator PPAR
Best taken with FOOD
May inc lithogenicity of the bile (4Fs)
DOC for: severe hypertriglyceridemia, chylomicronemia syndrome
Only two drugs that can increase HdL
Niacin and fibric acid derivatives
Crosses the placenta
Gemfibrozil
Ezetimibe
Adjunctive therapy with statins
Dec total and LDL-C levels, inhibits cholesterol absorption by enterocytes in the small intestine
Ae: myopathy, rare allergic interactions
Drug interactions: bile acid sequestrants inhibit absorption of ezetimibe
